Objective To investigate the detection of peritoneal free cancer cells and its clinical significance. Methods The peritoneal free cancer cells, the positive rates of CK20 protein and CK20 mRNA expressions of peritoneal lavage fluid were detected by peritoneal lavage cytology (PLC), flow cytometry (FCM) and real-time fluorescent quantitative RT-PCR in 50 cases of gastric cancer patients, respectively. The sensitivity of three kinds of detection method to peritoneal free cancer cells was compared. Results The positive rates of peritoneal free cancer cells, CK20 protein and mRNA expression of peritoneal lavage fluid were 20.0% (10/50), 36.0% (18/50) and 58.0% (29/50), respectively. The positive rate of CK20 mRNA expression detected by real-time fluorescencequantitative RT-PCR in peritoneal lavage fluid was significantly higher than those of the CK20 protein expression detected by FCM and peritoneal free cancer cells detected by PLC (Plt;0.05 or Plt;0.001). The difference of positive rate of CK20 protein expression and peritoneal free cancer cells was not significant (Pgt;0.05). The positive rate of CK20 mRNA expression of peritoneal lavage fluid was related to the tumor invasion depth, differentiation degree, TNM stage, and lymph node metastasis (Plt;0.05). Conclusion Real-time fluorescence quantitative RT-PCR is an effective method for the detection of peritoneal free cancer cells.
With the promotion of health awareness and the improvement of gastroscopy examination technology, the detection rate of early gastric cancer in our country had gradually increased. The early gastric cancer had a favorable prognosis and long-term survival. Improving the postoperative quality of life of patients with early gastric cancer had become one of the important directions in gastric cancer research. Under the premise of ensuring tumor radical resection, preserving partial gastric remnant function had become a hot topic in the treatment of early gastric cancer. Function preserving gastrectomy for early gastric cancer mainly included segmental gastrectomy, proximal gastrectomy, and local gastrectomy, among others. The author summarized the important research progress in function preserving gastrectomy at home and abroad in recent years, as well as the practical experiences of this center, aiming to provide reference for clinical surgeons to better carry out this type of surgery.
Forty-two patients with duodenal ulcer underwent highly selective vagotomy and mucosal antrectomy (HSV+MA) and were followed up for 3 years. Two weeks, 1 year and 3 year after operation, serum gastrim level and gastric emptying capacity were tested. The results show that he postoperative levels of serum gastrin were lower than the preoperative ones, but wih no significant difference (Ｐ＞0.05). Only a few patients had delayed gastric emptying 2 weeks and 1year after operation,but it returned to normal in 3 years .The authors conclude that HSV+MA is a better operative treatment for duodenal ulcer since it can abolish the factors of postoperative ulcer recurence and perserve the functions of the antrum and the pylorus.
Abstract: Objective To Evaluate the clinical outcome of gastric tube in radical surgeries to treat esophageal and cardial carcinoma. Methods From January to October 2008, 74 patients with esophageal or cardial carcinoma in Ruijin Hospital were enrolled in our study. Based on the surgical method, they were divided into the gastric tube group and the traditional way group. The gastric tube group had 46 patients, including 36 male patients and 10 female patients, whose age averaged 59.67±9.96 years (36 to 77 years). Among them, 31 patients had esophageal carcinoma with 1 upper, 23 middle and 7 lower esophageal carcinoma, and 15 patients had cardial carcinoma. In this group, 2 patients were treated with anastomosis in the left neck, 19 with anastomosis in the upper aortic arch, 10 with anastomosis in the lower aortic arch and 15 cardial carcinoma patients underwent radical resection. In the traditional way group, there were 28 patients, 25 male patients and 3 female patients, whose age averaged 59.17±11.33 years (37 to 86 years). In these patients, 22 had esophageal carcinoma with 1 in the upper esophagus, 17 in the middle esophagus, 4 in the lower esophagus; and 6 patients had cardial carcinoma. In this group, 2 patients were treated with anastomosis in the left neck , 17 with anastomosis in the upper aortic arch, 3 with anastomosis in the lower aortic arch, and 6 cardial carcinoma patients underwent radical resection. The rate of anastomotic leakage, operation time, and length of stay in hospital of these two groups were observed. Results All surgeries in the two groups were successfully performed. There was no anastomotic leakage case in the gastric tube group, while there were 4 pulmonary infection cases and 1 death case in the traditional way group. There was no statistically difference in the operation time (180.00±10.34 min vs. 185.00±6.23 min, t=1.669, P=0.078) and length of stay in hospital (16.78±9.98 d vs. 16.89±11.53 d, t=1.665, P=0.075) between the gastric tube group and the traditional way group. Conclusion Gastric tube has a good value in clinical application with fewercomplications and without prolonging operation and hospitalization time, which can surely better quality of life of the patients.